Division of Chest Wall Surgery, Nishinomiya Watanabe Cardiovascular Center, 3-25, Ikeda-cho, Nishinomiya, 662-0911, Japan.
Department of Pediatric Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Pediatr Surg Int. 2021 Jun;37(6):777-782. doi: 10.1007/s00383-021-04885-3. Epub 2021 Mar 19.
For the evaluation of the chest wall deformity, we adopted a non-invasive 3D body scanning system. The objective of this study is to evaluate surgical effect on the whole thorax using 3D scanning technique before and after Nuss procedure.
We performed 3D body scanning using Structure Sensor (Occipital Inc, USA) in 11 symmetric patients (average age 13 ± 3.2) under general anesthesia before and after Nuss procedure. Using the scanned data, the improved chest wall was analyzed using 3D-Rugle (Medic Engineering, Japan) imaging software. Preoperative and postoperative 3D data were super-imposed and a thoracic elevating distance in the line of the axial and sagittal section through the deepest point was calculated. Pre- and postoperative external sternal angle (ESA) were calculated from the scanned data.
Mean thoracic elevation distance at the deepest point was 38.6 ± 6.1 mm and it was 28.4 ± 5.1 mm and 19.4 ± 4.9 mm at 4 cm and 8 cm cranial side, respectively. Average ESA improved from 3.9 ± 1.6 degrees to 15.0 ± 1.1 degrees after the operation.
Chest depression was effectively elevated 39 mm at the deepest point after Nuss procedure. An indirect elevation effect by pectus bars was found on the wide area of the anterior chest.
为了评估胸廓畸形，我们采用了一种非侵入性的 3D 体扫描系统。本研究的目的是使用 3D 扫描技术评估 Nuss 手术后整个胸廓的手术效果。
我们在全麻下对 11 例对称患者（平均年龄 13±3.2 岁）进行了 Structure Sensor（Occipital Inc，美国）的 3D 体扫描。使用扫描数据，使用 3D-Rugle（Medic Engineering，日本）成像软件分析改良后的胸廓。将术前和术后的 3D 数据叠加，并计算通过最深点的轴向和矢状截面的胸廓提升距离。从扫描数据中计算术前和术后的胸骨外角（ESA）。
最深点的平均胸廓提升距离为 38.6±6.1mm，在颅侧 4cm 和 8cm 处分别为 28.4±5.1mm 和 19.4±4.9mm。平均 ESA 从术前的 3.9±1.6 度改善到术后的 15.0±1.1 度。
Nuss 手术后最深点的胸廓凹陷有效抬高了 39mm。通过肋弓可以在胸廓前区的广泛区域产生间接抬高的效果。
